US20220057635A1 - Presenting visual and thermal images in a headset during phacoemulsification - Google Patents
Presenting visual and thermal images in a headset during phacoemulsification Download PDFInfo
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Definitions
- the present invention relates generally to medical imaging, and specifically to presenting, in a headset, visual and/or thermal images of an eye during a phacoemulsification procedure.
- magnification devices such as microscopes for visualization and magnification of a surgical site.
- surgery using a microscope can pose some challenges for the surgeon, because the surgical site can be viewed only when the surgeon's eyes are directly aligned with the microscope's eyepieces. Therefore, if a surgeon wants to check settings or surgical parameters of the surgical system, the surgeon may need to pause the surgery, change his or her gaze from the surgical site to a surgical console that shows the settings, and then turn back to the surgical site. While this may take only a few seconds each time, the multiple pauses may decrease the efficiency of the surgery.
- surgeon may be required to hold his or her head at an awkward angle in order to look through the microscope. Over time, fatigue may make this position uncomfortable.
- U.S. Patent Application 2014/0121669 to Claus describes a method for controlling a phacoemulsification system based on real-time analysis of image data.
- the method includes detecting surgical events from image data collected by a surgical microscope focused on an ocular surgical procedure, establishing a desired response for each detected surgical event, delivering the desired response to the ocular surgical instrument as a set of software instructions, and altering the surgical procedure based on the desired response received as the set of software instructions.
- U.S. Patent Application 2012/0022546 to Hubschman et al. describes a method for providing a surgeon with guidance concerning a distance separating a working end of a phacoemulsification instrument and the posterior portion of the capsule of the eye during surgical procedures.
- the method includes visual and/or auditory conveyance of distance information to the surgeon wherein visual information may be conveyed by overlaying it with real visual images of actual surface features viewed by the surgeon.
- U.S. Patent Application 2018/0168741 to Swayze et al. describes a surgical system with an augmented reality display.
- the system includes a detector that comprises an array of pixels configured to detect light reflected by a surgical device and generate a first signal that includes an image of the surgical device.
- the surgical system may also include a processor configured to receive the first signal and a second signal representative of one or more operating parameters of the surgical device, and to generate a modified image of the surgical device that includes information related to one or more operating parameters.
- a surgical imaging system including a first imaging device configured to generate a real-time visual image of a first field of view of a patient, a second imaging device configured to generate a real-time thermal image of the first field of view, a retaining structure, configured to be positioned in proximity to an eye of an operator of the system, a semi-transparent screen configured to be mounted on the structure in front of the eye of the operator, and a processor configured to receive the real-time visual and thermal images from the imaging devices, and upon receiving an indication from the operator, to present, on the semi-transparent screen, the real-time visual image, the real-time thermal image or the real-time thermal image overlaid on the real-time visual image, focused to a point in proximity to a near point of the eye of the operator while the operator is capable of viewing through the semi-transparent screen a second field of view different from the first field of view.
- the surgical imaging system is configured to present the real-time image, the real-time thermal image or the real-time thermal image overlaid on the real-time visual image by toggling, on the semi-transparent screen, the presentation of the real-time image, the real-time thermal image and the real-time thermal image overlaid on the real-time visual image in a round-robin fashion
- the first field of view of the patient includes one or more surgical tools used to perform a surgical procedure on the patient.
- the first field of view includes an eye of the patient, and the surgical tools are used to perform the surgical procedure on the eye of the patient.
- the surgical procedure includes phacoemulsification.
- the thermal image includes temperature information for tissue in the eye of the patient and the one or more surgical tools.
- the processor is further configured to present, on the semi-transparent screen, information about the surgical procedure.
- a method for viewing a surgical procedure including receiving a real-time visual image from a first imaging device having a first field of view of a patient, receiving a real-time thermal image from a second imaging device having the first field of view, and upon receiving an indication from an operator, presenting, by a processor on a semi-transparent screen, the real-time visual image, the real-time thermal image or the real-time thermal image overlaid on the real-time visual image, focused to a point in proximity to a near point of the eye of the operator while the operator is capable of viewing through the semi-transparent screen a second field of view different from the first field of view, wherein the semi-transparent screen is in front of an eye of an operator of the system and is mounted on a retaining structure positioned in proximity to the eye of the operator.
- a computer software product including a non-transitory computer-readable medium, in which program instructions are stored, which instructions, when read by a computer, cause the computer to receive a real-time visual image from a first imaging device having a first field of view of a patient, to receive a real-time thermal image from a second imaging device having the first field of view, and to present, on a semi-transparent screen upon receiving an indication from an operator, the real-time visual image, the real-time thermal image or the real-time thermal image overlaid on the real-time visual image, focused to a point in proximity to a near point of the eye of the operator while the operator is capable of viewing through the semi-transparent screen a second field of view different from the first field of view, wherein the semi-transparent screen is in front of an eye of an operator of the system and mounted on a retaining structure positioned in proximity to the eye of the operator.
- FIG. 1 is a schematic pictorial illustration of a medical system 20 comprising a visible spectrum camera and a thermal camera that capture real-time images of an eye during a phacoemulsification procedure, in accordance with an embodiment of the present invention
- FIG. 2 is a schematic pictorial illustration of a phacoemulsification probe performing a phacoemulsification procedure, in accordance with an embodiment of the present invention
- FIG. 3 is a schematic pictorial illustration of a headset that can be worn by a surgeon, and is configured to present, to the surgeon, the real time images captured by the visible spectrum and thermal cameras, in accordance with an embodiment of the present invention
- FIG. 4 is a schematic pictorial illustration of a real-time visible spectrum image of an eye during a phacoemulsification procedure that is captured by the visible spectrum camera, in accordance with an embodiment of the present invention
- FIG. 5 is a schematic pictorial illustration of a real-time thermal image of an eye during the phacoemulsification procedure that is captured by the thermal camera, in accordance with an embodiment of the present invention
- FIG. 6 is a schematic pictorial illustration of the real-time thermal image overlaid on the real-time visible spectrum image, in accordance with an embodiment of the present invention.
- FIG. 7 is a flow diagram that schematically illustrates a method of presenting the real-time images in the headset worn by the surgeon during a phacoemulsification procedure, in accordance with an embodiment of the present invention.
- a surgeon positions a phacoemulsification tool so that a needle at the distal end of the tool engages a lens of the eye.
- the surgeon can instruct the tool to deliver ultrasonic energy to the needle so as to emulsify the lens.
- the handle While emulsifying the lens, the handle may heat up as a result of the ultrasonic energy generated in the handle. The heat generation may be minimized by maintaining elements of the probe in resonance, but this is no easy matter because of the numerous and variable resonances (mechanical and electrical) of the probe.
- the eye is extremely sensitive to heat, and should not be raised to a temperature greater than 42° C. Thus, during a phacoemulsification procedure, even when probe elements are generating minimum heat, it is important to monitor temperature of the eye tissue.
- Embodiments of the present invention provide a method and a system for presenting, to a headset worn by a surgeon, visual (i.e., visible spectrum) and thermal images of a phacoemulsification procedure.
- the system may comprise a first imaging device configured to generate a real-time visual image of a first field of view of a patient, and a second imaging device configured to generate a real-time thermal image of the first field of view.
- the first field of view is typically defined by optics of the first and the second imaging devices.
- the headset may also comprise a retaining structure, configured to be positioned in proximity to an eye of an operator of the system, and a semi-transparent screen configured to be mounted on the structure in front of the eye of the operator.
- a retaining structure configured to be positioned in proximity to an eye of an operator of the system
- a semi-transparent screen configured to be mounted on the structure in front of the eye of the operator.
- the operator When looking through the semi-transparent screen, the operator has a second field of view that is typically defined by the retaining structure, in a manner similar to the field of view of an eyeglasses wearer being defined by the frame of the eyeglasses.
- the system may additionally comprise a processor configured to receive the real-time visual and thermal images from the imaging devices.
- the processor can be configured to present, on the semi-transparent screen, the real-time visual image, the real-time thermal image or the thermal image overlaid on the visual image.
- the image (i.e., the real-time visual image, the real-time thermal image or the thermal image overlaid on the visual image) presented on the semi-transparent screen can be focused to a point in proximity to a near point of the eye of the operator while the operator is capable of viewing through the semi-transparent screen the second field of view different from the first field of view.
- the near point of the eye indicates the closest point (typically around 25 centimeters) at which an object can be placed and so as to form a focused image on the retina.
- systems implementing embodiments of the present invention can present, to the surgeon on the semi-transparent screen, the visual or thermal images of the eye being treated when the surgeon's eye is focused on a point in proximity to the near point of the eye.
- the surgeon can view the patient in the second field of view, by “looking through” the semi-transparent screen.
- the system can present, to the surgeon on the semi-transparent screen, guidance, and other information on the procedure in progress.
- FIG. 1 is a schematic pictorial illustration of a medical system 20 configured to be used when performing a phacoemulsification procedure, in accordance with an embodiment of the present invention.
- medical system 20 comprises a phacoemulsification probe 22 and a medical imaging system 24 that are both coupled to a control console 26 .
- Phacoemulsification probe 22 is described in the description referencing FIG. 2 hereinbelow.
- Medical imaging system 24 comprises a visible spectrum camera 28 that is configured to capture and generate a real-time visible spectrum image 30 ( FIG. 4 ), also referred to herein as visual image 30 , of a field of view 32 comprising a patient 34 , and a thermal camera 36 that is configured to capture and generate a real-time thermal image 38 (i.e., an image in the far infra-red) of field of view 32 comprising the patient.
- a visible spectrum camera 28 that is configured to capture and generate a real-time visible spectrum image 30 ( FIG. 4 ), also referred to herein as visual image 30 , of a field of view 32 comprising a patient 34
- a thermal camera 36 that is configured to capture and generate a real-time thermal image 38 (i.e., an image in the far infra-red) of field of view 32 comprising the patient.
- cameras 28 and 36 may also be referred to as imaging devices 28 and 36 .
- field of view 32 (also referred to herein as a first field of view) is typically governed by optics of visible spectrum camera 28 and thermal camera 36 . While the configuration in FIG. 1 shows a single field of view 32 for cameras 28 and 36 , cameras having different fields of view, but with a common sub-field of view that comprises patient 34 , are considered to be within the spirit and scope of the present invention.
- a medical professional 40 typically uses surgical tools such as phacoemulsification probe 22 and a secondary instrument 42 to perform a phacoemulsification procedure on an eye 44 of patient 34 .
- medical professional 40 can wear a headset 46 that presents visual image 30 and/or real-time thermal image 38 ( FIG. 5 ) to the medical professional 40 .
- headset 46 can receive the images in wireless signals received from console 26 . Headset 46 is described in the description referencing FIG. 3 hereinbelow.
- Control console 26 may also comprise a processor 48 .
- Processor 48 may comprise real-time noise reduction circuitry 50 typically configured as a field programmable gate array (FPGA), followed by an analog-to-digital (A/D) signal conversion integrated circuit 52 .
- the processor can pass the signal from A/D circuit 52 to another processor and/or can be programmed to perform one or more algorithms disclosed herein, each of the one or more algorithms comprising steps described hereinbelow.
- the processor uses circuitry 50 and circuit 52 , as well as features of modules which are described in more detail below, in order to perform the one or more algorithms.
- Control console 26 may additionally comprise a memory 54 that is configured to store images 30 and 38 .
- processor 48 can generate, and store to memory 54 , a real-time image 56 that comprises visual image 30 and/or thermal image 38 , as well as procedure information that can be useful to medical professional 40 performing a phacoemulsification procedure.
- Memory 54 may comprise any suitable volatile and/or non-volatile memory, such as random-access memory or a hard disk drive.
- console 26 also comprises a wireless transmitter 58 and an input/output (I/O) communications interface 60 .
- Wireless transmitter 58 can be configured to transmit wireless signals 62 comprising real-time image 56 to headset 46 .
- I/O interface 60 enables control console 26 to transfer images 30 and 38 from cameras 28 and 36 to memory 54 , and to transfer real-time image 56 from the memory to wireless transmitter 58 .
- Console 26 may also comprise an irrigation module 64 , and a pump 66 .
- Irrigation module 64 is configured to deliver an irrigation fluid (e.g., a saline solution) to phacoemulsification probe 22 at a controllable rate.
- irrigation fluid e.g., a saline solution
- pump 66 The operation of pump 66 is described in the description referencing FIG. 2 hereinbelow.
- processor 48 can present information 68 (e.g., images 30 , 38 or 56 ) about the procedure to medical professional 40 on a display 70 .
- medical system 20 may comprise a physical input device, such as a pedal 72 , that medical professional 40 may use to control the presentation of images 30 and 38 on headset 46 , as described hereinbelow.
- medical console 26 also comprises a voice capture device 74 (e.g., a microphone) and a voice recognition module 76 .
- voice capture device 74 can capture a vocal input from medical professional 40 , and convey the vocal input to voice recognition module 76 .
- Voice recognition module 76 can translate the received vocal input into instructions that processor 48 can process so as to control the presentation of images 30 and/or 38 on headset 46 .
- FIG. 2 is a schematic pictorial illustration of phacoemulsification probe 22 performing a phacoemulsification procedure on a cataract 80 in a lens 81 of eye 44 , in accordance with an embodiment of the present invention.
- Phacoemulsification probe 22 comprises a handle 82 comprising a shaft 84 that extends from a distal end 86 of the handle, and a needle 88 that extends from a distal end 90 of the shaft.
- shaft 84 may also comprise an irrigation lumen 92 that can deliver irrigation fluid from irrigation module 64 to eye 44
- needle 88 may comprise an aspiration lumen 94 through which pump 66 can aspirate particles from the eye.
- Phacoemulsification probe 22 may also comprise an ultrasonic transducer 96 .
- medical professional 40 manipulates handle 82 so as insert needle 88 through a cornea 98 of eye 44 so as to treat cataract 80 .
- ultrasonic transducer 96 In response to medical professional 40 pressing a button 100 on handle (or in an alternate embodiment, a foot pedal may be used), ultrasonic transducer 96 generates vibration energy which it transfers to needle 88 , and the vibration energy from the needle sculpt and emulsify lens 81 .
- vibrating needle 88 can break up lens 81 into multiple pieces, and each of the pieces is emulsified and aspirated out by suction pump 66 via lumen 94 .
- FIG. 3 is a schematic pictorial illustration of medical professional 40 wearing headset 46 , in accordance with an embodiment of the present invention.
- Headset 46 comprises a retaining structure 110 that is configured to be positioned in proximity to left and right eyes 112 of medical professional 40 , and substantially similar semi-transparent screens 114 that are configured to be mounted respectively on the retaining structure in front of eyes 112 .
- headset 46 also comprises a wireless receiver 116 that is configured to receive wireless signals 62 comprising real-time image 56 , and an image projector 118 that is configured to present, on screens 114 , the received real-time image, as described hereinbelow.
- image projector 118 can be configured to present, on semi-transparent screens 114 , real-time image 56 focused to a point 120 in proximity to a near point 122 of eyes 112 .
- Near point 122 is approximately 25 centimeters from each given eye 112 , and references the closest point at which an object can be placed in front of the given eye so as to form a focused image on the eye's retina, (i.e., within the eye's accommodation range).
- eyes 112 if eyes 112 are focused on point 120 , then eyes 112 will “see” real-time image 56 . However, if eyes 112 are focused on a point 124 that is beyond near point 122 , then eyes 112 will see point 124 “through” semi-transparent screens 114 . When eyes 112 see point 124 “through” semi-transparent screens 114 , eyes 112 have a field of view 126 (also referred to herein as a second field of view), defined by retaining structure 110 , that is different than field of view 32 .
- a field of view 126 also referred to herein as a second field of view
- medical professional 40 can see patient 34 in field of view 126 if eyes 112 are focused on point 124 (e.g., on the patient), and can view the patient in field of view 32 if eyes 112 are focused on point 120 .
- FIG. 4 is a schematic pictorial illustration of real-time image 56 comprising visual image 30 of eye 44 and surgical tools such as probe 22 and secondary instrument 42 during a phacoemulsification procedure, in accordance with an embodiment of the present invention.
- processor 48 can generate real-time image 56 by overlaying, on visual image 30 , procedure information 130 .
- information 130 that processor 48 can overlay on real-time image 30 include, but are not limited to, a stroboscopic video showing movement of needle 88 , current power applied to ultrasonic transducer 96 and pump flow for irrigation module 64 .
- FIG. 5 is a schematic pictorial illustration of real-time image 56 comprising real-time thermal image 38 of eye 44 and surgical tools such as probe 22 and secondary instrument 42 during a phacoemulsification procedure, in accordance with an embodiment of the present invention.
- FIG. 5 illustrates real-time image 56 in gray scale, but it will be understood that typically the image is a color image, with different colors representing different temperatures.
- Thermal image 38 conveys temperature information for tissue in eye 44 and surgical instruments 22 and 42 .
- FIG. 6 is a schematic pictorial illustration of real-time image 56 comprising real-time thermal image 38 overlaid on visual image 30 during a phacoemulsification procedure, in accordance with an embodiment of the present invention.
- processor 48 can generate real-time image 56 by overlaying, on images 30 and 38 , procedure information 130 .
- FIG. 7 is a flow diagram that schematically illustrates a method of presenting, on semi-transparent screens 114 , real-time image 56 of a phacoemulsification procedure, in accordance with an embodiment of the present invention.
- medical professional 40 positions patient 34 so that eye 44 (i.e., the eye to be treated) is within field of view 32 .
- processor 48 presents real-time visual spectrum image 30 on semi-transparent screens 114 .
- processor 48 can receive the real-time visual spectrum image 30 from camera 28 , generate real-time image 56 from the received image, and transmit, via transmitter 58 , the generated real-time image 56 in wireless signal 62 .
- image projector 118 can present real-time image 56 on semi-transparent screens 114 .
- image projector 118 presents real-time image 56 on semi-transparent screens 114 focused to point 120 in proximity to near point 122 .
- processor 48 specifies an image toggling sequence for content to present in real-time image 56 on semi-transparent screens 114 .
- processor 48 can specify the sequence as follows:
- processor 48 can receive the real-time thermal image 38 from camera 36 , generate real-time image 56 from the received image, and transmit, via transmitter 58 , the generated real-time image 56 in wireless signal 62 .
- image projector 118 can present real-time image 56 on semi-transparent screens 114 .
- processor 48 can receive the real-time visual spectrum image 30 from camera 28 , receive the real-time thermal image 38 from camera 36 , register the received thermal image 38 to the received visual image 30 , generate real-time image 56 by overlaying the received thermal image 38 on the received visual image 30 , and transmit, via transmitter 58 , the generated real-time image 56 in wireless signal 62 .
- image projector 118 can present real-time image 56 on semi-transparent screens 114 .
- thermal camera 36 is registered to visual spectrum image camera 30 (or vice versa) prior to the phacoemulsification procedure, using techniques known in the art.
- an individual e.g., medical professional 40
- medical professional inserts needle into eye 44 , and manipulates handle 82 so that the needle engages lens 81 in eye 44 .
- medical professional 40 starts the phacoemulsification procedure to emulsify lens 81 .
- medical professional 40 presses button 100 (or in an alternate embodiment a foot pedal), and in response to the pressed button, ultrasonic transducer conveys ultrasonic energy to needle 88 .
- the ultrasonic energy causes the needle to vibrate and emulsify tissue of lens 81 in proximity to needle 88 .
- processor 48 checks if there is an image toggle request from medical professional 40 .
- medical professional 40 can send the image toggle request by pressing on pedal 72 or a button located on pedal 72 .
- processor 48 toggles the presentation of real-time image 56 on semi-transparent screens 114 per the image toggling sequence described supra.
- a second decision step 154 if the emulsification of lens 81 is not complete, then the method returns to step 150 . The method ends when the emulsification of lens 81 is completed or when indicated by medical professional 40 .
- step 150 if processor 48 does not receive an image toggle request, then the method continues with step 154 .
- medical system 20 may comprise first, second and third physical input devices, herein, by way of example, assumed to comprise additional pedals 72 or additional buttons 100 .
- processor 48 in response to an input from the first input device, processor 48 generates real-time image 56 comprising real-time visual spectrum image 30 , in response to an input from the second input device, processor 48 generates real-time image 56 comprising real-time thermal image 38 , and in response to an input from the third input device, processor 48 generates real-time image 56 comprising real-time thermal image 38 overlaid on real-time visual spectrum image 30 .
- processor 48 can use signals from voice recognition module 76 to toggle or select the content in real-time image 56 based on vocal inputs from medical professional 40 .
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Abstract
Description
- The present invention relates generally to medical imaging, and specifically to presenting, in a headset, visual and/or thermal images of an eye during a phacoemulsification procedure.
- Because of the delicate nature of some eye surgeries such as phacoemulsification, ophthalmic surgeons can use magnification devices such as microscopes for visualization and magnification of a surgical site. However, surgery using a microscope can pose some challenges for the surgeon, because the surgical site can be viewed only when the surgeon's eyes are directly aligned with the microscope's eyepieces. Therefore, if a surgeon wants to check settings or surgical parameters of the surgical system, the surgeon may need to pause the surgery, change his or her gaze from the surgical site to a surgical console that shows the settings, and then turn back to the surgical site. While this may take only a few seconds each time, the multiple pauses may decrease the efficiency of the surgery.
- In addition, the surgeon may be required to hold his or her head at an awkward angle in order to look through the microscope. Over time, fatigue may make this position uncomfortable.
- U.S. Patent Application 2014/0121669 to Claus describes a method for controlling a phacoemulsification system based on real-time analysis of image data. In some embodiments, the method includes detecting surgical events from image data collected by a surgical microscope focused on an ocular surgical procedure, establishing a desired response for each detected surgical event, delivering the desired response to the ocular surgical instrument as a set of software instructions, and altering the surgical procedure based on the desired response received as the set of software instructions.
- U.S. Patent Application 2012/0022546 to Hubschman et al., describes a method for providing a surgeon with guidance concerning a distance separating a working end of a phacoemulsification instrument and the posterior portion of the capsule of the eye during surgical procedures. In some embodiments, the method includes visual and/or auditory conveyance of distance information to the surgeon wherein visual information may be conveyed by overlaying it with real visual images of actual surface features viewed by the surgeon.
- U.S. Patent Application 2018/0168741 to Swayze et al., describes a surgical system with an augmented reality display. In some embodiments, the system includes a detector that comprises an array of pixels configured to detect light reflected by a surgical device and generate a first signal that includes an image of the surgical device. The surgical system may also include a processor configured to receive the first signal and a second signal representative of one or more operating parameters of the surgical device, and to generate a modified image of the surgical device that includes information related to one or more operating parameters.
- The description above is presented as a general overview of related art in this field and should not be construed as an admission that any of the information it contains constitutes prior art against the present patent application.
- There is provided, in accordance with an embodiment of the present invention, a surgical imaging system, including a first imaging device configured to generate a real-time visual image of a first field of view of a patient, a second imaging device configured to generate a real-time thermal image of the first field of view, a retaining structure, configured to be positioned in proximity to an eye of an operator of the system, a semi-transparent screen configured to be mounted on the structure in front of the eye of the operator, and a processor configured to receive the real-time visual and thermal images from the imaging devices, and upon receiving an indication from the operator, to present, on the semi-transparent screen, the real-time visual image, the real-time thermal image or the real-time thermal image overlaid on the real-time visual image, focused to a point in proximity to a near point of the eye of the operator while the operator is capable of viewing through the semi-transparent screen a second field of view different from the first field of view.
- In some embodiments, the surgical imaging system is configured to present the real-time image, the real-time thermal image or the real-time thermal image overlaid on the real-time visual image by toggling, on the semi-transparent screen, the presentation of the real-time image, the real-time thermal image and the real-time thermal image overlaid on the real-time visual image in a round-robin fashion
- In additional embodiments, the first field of view of the patient includes one or more surgical tools used to perform a surgical procedure on the patient.
- In one embodiment, the first field of view includes an eye of the patient, and the surgical tools are used to perform the surgical procedure on the eye of the patient.
- In another embodiment, the surgical procedure includes phacoemulsification.
- In an additional embodiment, the thermal image includes temperature information for tissue in the eye of the patient and the one or more surgical tools.
- In a supplemental embodiment, the processor is further configured to present, on the semi-transparent screen, information about the surgical procedure.
- There is also provided, in accordance with an embodiment of the present invention, a method for viewing a surgical procedure, including receiving a real-time visual image from a first imaging device having a first field of view of a patient, receiving a real-time thermal image from a second imaging device having the first field of view, and upon receiving an indication from an operator, presenting, by a processor on a semi-transparent screen, the real-time visual image, the real-time thermal image or the real-time thermal image overlaid on the real-time visual image, focused to a point in proximity to a near point of the eye of the operator while the operator is capable of viewing through the semi-transparent screen a second field of view different from the first field of view, wherein the semi-transparent screen is in front of an eye of an operator of the system and is mounted on a retaining structure positioned in proximity to the eye of the operator.
- There is additionally provided, in accordance with an embodiment of the present invention, a computer software product including a non-transitory computer-readable medium, in which program instructions are stored, which instructions, when read by a computer, cause the computer to receive a real-time visual image from a first imaging device having a first field of view of a patient, to receive a real-time thermal image from a second imaging device having the first field of view, and to present, on a semi-transparent screen upon receiving an indication from an operator, the real-time visual image, the real-time thermal image or the real-time thermal image overlaid on the real-time visual image, focused to a point in proximity to a near point of the eye of the operator while the operator is capable of viewing through the semi-transparent screen a second field of view different from the first field of view, wherein the semi-transparent screen is in front of an eye of an operator of the system and mounted on a retaining structure positioned in proximity to the eye of the operator.
- The disclosure is herein described, by way of example only, with reference to the accompanying drawings, wherein:
-
FIG. 1 is a schematic pictorial illustration of amedical system 20 comprising a visible spectrum camera and a thermal camera that capture real-time images of an eye during a phacoemulsification procedure, in accordance with an embodiment of the present invention; -
FIG. 2 is a schematic pictorial illustration of a phacoemulsification probe performing a phacoemulsification procedure, in accordance with an embodiment of the present invention; -
FIG. 3 is a schematic pictorial illustration of a headset that can be worn by a surgeon, and is configured to present, to the surgeon, the real time images captured by the visible spectrum and thermal cameras, in accordance with an embodiment of the present invention; -
FIG. 4 is a schematic pictorial illustration of a real-time visible spectrum image of an eye during a phacoemulsification procedure that is captured by the visible spectrum camera, in accordance with an embodiment of the present invention; -
FIG. 5 is a schematic pictorial illustration of a real-time thermal image of an eye during the phacoemulsification procedure that is captured by the thermal camera, in accordance with an embodiment of the present invention; -
FIG. 6 is a schematic pictorial illustration of the real-time thermal image overlaid on the real-time visible spectrum image, in accordance with an embodiment of the present invention; and -
FIG. 7 is a flow diagram that schematically illustrates a method of presenting the real-time images in the headset worn by the surgeon during a phacoemulsification procedure, in accordance with an embodiment of the present invention. - In a phacoemulsification procedure for an eye with a cataract, a surgeon positions a phacoemulsification tool so that a needle at the distal end of the tool engages a lens of the eye. Upon engaging the lens, the surgeon can instruct the tool to deliver ultrasonic energy to the needle so as to emulsify the lens. While emulsifying the lens, the handle may heat up as a result of the ultrasonic energy generated in the handle. The heat generation may be minimized by maintaining elements of the probe in resonance, but this is no easy matter because of the numerous and variable resonances (mechanical and electrical) of the probe. In addition, the eye is extremely sensitive to heat, and should not be raised to a temperature greater than 42° C. Thus, during a phacoemulsification procedure, even when probe elements are generating minimum heat, it is important to monitor temperature of the eye tissue.
- Embodiments of the present invention provide a method and a system for presenting, to a headset worn by a surgeon, visual (i.e., visible spectrum) and thermal images of a phacoemulsification procedure. As explained hereinbelow, the system may comprise a first imaging device configured to generate a real-time visual image of a first field of view of a patient, and a second imaging device configured to generate a real-time thermal image of the first field of view. The first field of view is typically defined by optics of the first and the second imaging devices.
- The headset may also comprise a retaining structure, configured to be positioned in proximity to an eye of an operator of the system, and a semi-transparent screen configured to be mounted on the structure in front of the eye of the operator. When looking through the semi-transparent screen, the operator has a second field of view that is typically defined by the retaining structure, in a manner similar to the field of view of an eyeglasses wearer being defined by the frame of the eyeglasses.
- The system may additionally comprise a processor configured to receive the real-time visual and thermal images from the imaging devices. Upon receiving an indication from an operator, the processor can be configured to present, on the semi-transparent screen, the real-time visual image, the real-time thermal image or the thermal image overlaid on the visual image.
- In embodiments of the present invention, the image (i.e., the real-time visual image, the real-time thermal image or the thermal image overlaid on the visual image) presented on the semi-transparent screen can be focused to a point in proximity to a near point of the eye of the operator while the operator is capable of viewing through the semi-transparent screen the second field of view different from the first field of view. In embodiments described herein, the near point of the eye indicates the closest point (typically around 25 centimeters) at which an object can be placed and so as to form a focused image on the retina.
- During a phacoemulsification procedure, systems implementing embodiments of the present invention can present, to the surgeon on the semi-transparent screen, the visual or thermal images of the eye being treated when the surgeon's eye is focused on a point in proximity to the near point of the eye. However, if the surgeon is focused on the patient (i.e., at a point that is typically not in proximity to the near point of the eye) the surgeon can view the patient in the second field of view, by “looking through” the semi-transparent screen.
- In additional embodiments, the system can present, to the surgeon on the semi-transparent screen, guidance, and other information on the procedure in progress.
-
FIG. 1 is a schematic pictorial illustration of amedical system 20 configured to be used when performing a phacoemulsification procedure, in accordance with an embodiment of the present invention. In the example shown inFIG. 1 ,medical system 20 comprises aphacoemulsification probe 22 and amedical imaging system 24 that are both coupled to acontrol console 26.Phacoemulsification probe 22 is described in the description referencingFIG. 2 hereinbelow. -
Medical imaging system 24 comprises avisible spectrum camera 28 that is configured to capture and generate a real-time visible spectrum image 30 (FIG. 4 ), also referred to herein asvisual image 30, of a field ofview 32 comprising apatient 34, and athermal camera 36 that is configured to capture and generate a real-time thermal image 38 (i.e., an image in the far infra-red) of field ofview 32 comprising the patient. In embodiments herein,cameras imaging devices - As described supra, field of view 32 (also referred to herein as a first field of view) is typically governed by optics of
visible spectrum camera 28 andthermal camera 36. While the configuration inFIG. 1 shows a single field ofview 32 forcameras patient 34, are considered to be within the spirit and scope of the present invention. - A medical professional 40 (also referred to herein as an operator) typically uses surgical tools such as
phacoemulsification probe 22 and asecondary instrument 42 to perform a phacoemulsification procedure on aneye 44 ofpatient 34. In embodiments described herein, medical professional 40 can wear aheadset 46 that presentsvisual image 30 and/or real-time thermal image 38 (FIG. 5 ) to themedical professional 40. In some embodiments,headset 46 can receive the images in wireless signals received fromconsole 26.Headset 46 is described in the description referencingFIG. 3 hereinbelow. -
Control console 26 may also comprise aprocessor 48.Processor 48 may comprise real-timenoise reduction circuitry 50 typically configured as a field programmable gate array (FPGA), followed by an analog-to-digital (A/D) signal conversion integratedcircuit 52. The processor can pass the signal from A/D circuit 52 to another processor and/or can be programmed to perform one or more algorithms disclosed herein, each of the one or more algorithms comprising steps described hereinbelow. The processor usescircuitry 50 andcircuit 52, as well as features of modules which are described in more detail below, in order to perform the one or more algorithms. -
Control console 26 may additionally comprise amemory 54 that is configured to storeimages processor 48 can generate, and store tomemory 54, a real-time image 56 that comprisesvisual image 30 and/orthermal image 38, as well as procedure information that can be useful to medical professional 40 performing a phacoemulsification procedure.Memory 54 may comprise any suitable volatile and/or non-volatile memory, such as random-access memory or a hard disk drive. - In the configuration shown in
FIG. 1 ,console 26 also comprises awireless transmitter 58 and an input/output (I/O)communications interface 60.Wireless transmitter 58 can be configured to transmitwireless signals 62 comprising real-time image 56 toheadset 46. I/O interface 60 enablescontrol console 26 to transferimages cameras memory 54, and to transfer real-time image 56 from the memory towireless transmitter 58. -
Console 26 may also comprise anirrigation module 64, and apump 66.Irrigation module 64 is configured to deliver an irrigation fluid (e.g., a saline solution) tophacoemulsification probe 22 at a controllable rate. The operation ofpump 66 is described in the description referencingFIG. 2 hereinbelow. - During a phacoemulsification procedure,
processor 48 can present information 68 (e.g.,images display 70. In some embodiments,medical system 20 may comprise a physical input device, such as apedal 72, that medical professional 40 may use to control the presentation ofimages headset 46, as described hereinbelow. - In the configuration shown in
FIG. 1 ,medical console 26 also comprises a voice capture device 74 (e.g., a microphone) and avoice recognition module 76. In some embodiments,voice capture device 74 can capture a vocal input from medical professional 40, and convey the vocal input tovoice recognition module 76.Voice recognition module 76 can translate the received vocal input into instructions thatprocessor 48 can process so as to control the presentation ofimages 30 and/or 38 onheadset 46. -
FIG. 2 is a schematic pictorial illustration ofphacoemulsification probe 22 performing a phacoemulsification procedure on acataract 80 in alens 81 ofeye 44, in accordance with an embodiment of the present invention.Phacoemulsification probe 22 comprises ahandle 82 comprising ashaft 84 that extends from adistal end 86 of the handle, and aneedle 88 that extends from adistal end 90 of the shaft. In some embodiments,shaft 84 may also comprise anirrigation lumen 92 that can deliver irrigation fluid fromirrigation module 64 to eye 44, andneedle 88 may comprise anaspiration lumen 94 through which pump 66 can aspirate particles from the eye. -
Phacoemulsification probe 22 may also comprise anultrasonic transducer 96. In the example shown inFIG. 2 , medical professional 40 manipulates handle 82 so asinsert needle 88 through acornea 98 ofeye 44 so as to treatcataract 80. In response to medical professional 40 pressing abutton 100 on handle (or in an alternate embodiment, a foot pedal may be used),ultrasonic transducer 96 generates vibration energy which it transfers toneedle 88, and the vibration energy from the needle sculpt and emulsifylens 81. During the procedure, vibratingneedle 88 can break uplens 81 into multiple pieces, and each of the pieces is emulsified and aspirated out bysuction pump 66 vialumen 94. -
FIG. 3 is a schematic pictorial illustration of medical professional 40 wearingheadset 46, in accordance with an embodiment of the present invention.Headset 46 comprises a retainingstructure 110 that is configured to be positioned in proximity to left andright eyes 112 of medical professional 40, and substantially similarsemi-transparent screens 114 that are configured to be mounted respectively on the retaining structure in front ofeyes 112. - In the configuration shown in
FIG. 3 ,headset 46 also comprises awireless receiver 116 that is configured to receivewireless signals 62 comprising real-time image 56, and animage projector 118 that is configured to present, onscreens 114, the received real-time image, as described hereinbelow. In some embodiments,image projector 118 can be configured to present, onsemi-transparent screens 114, real-time image 56 focused to apoint 120 in proximity to anear point 122 ofeyes 112. Nearpoint 122 is approximately 25 centimeters from each giveneye 112, and references the closest point at which an object can be placed in front of the given eye so as to form a focused image on the eye's retina, (i.e., within the eye's accommodation range). - In other words, if
eyes 112 are focused onpoint 120, theneyes 112 will “see” real-time image 56. However, ifeyes 112 are focused on apoint 124 that is beyondnear point 122, theneyes 112 will seepoint 124 “through”semi-transparent screens 114. Wheneyes 112 seepoint 124 “through”semi-transparent screens 114,eyes 112 have a field of view 126 (also referred to herein as a second field of view), defined by retainingstructure 110, that is different than field ofview 32. Therefore, during a surgical procedure such as phacoemulsification, medical professional 40 can seepatient 34 in field ofview 126 ifeyes 112 are focused on point 124 (e.g., on the patient), and can view the patient in field ofview 32 ifeyes 112 are focused onpoint 120. -
FIG. 4 is a schematic pictorial illustration of real-time image 56 comprisingvisual image 30 ofeye 44 and surgical tools such asprobe 22 andsecondary instrument 42 during a phacoemulsification procedure, in accordance with an embodiment of the present invention. In some embodiments,processor 48 can generate real-time image 56 by overlaying, onvisual image 30,procedure information 130. Examples ofinformation 130 thatprocessor 48 can overlay on real-time image 30 include, but are not limited to, a stroboscopic video showing movement ofneedle 88, current power applied toultrasonic transducer 96 and pump flow forirrigation module 64. -
FIG. 5 is a schematic pictorial illustration of real-time image 56 comprising real-timethermal image 38 ofeye 44 and surgical tools such asprobe 22 andsecondary instrument 42 during a phacoemulsification procedure, in accordance with an embodiment of the present invention.FIG. 5 illustrates real-time image 56 in gray scale, but it will be understood that typically the image is a color image, with different colors representing different temperatures.Thermal image 38 conveys temperature information for tissue ineye 44 andsurgical instruments -
FIG. 6 is a schematic pictorial illustration of real-time image 56 comprising real-timethermal image 38 overlaid onvisual image 30 during a phacoemulsification procedure, in accordance with an embodiment of the present invention. In some embodiments,processor 48 can generate real-time image 56 by overlaying, onimages procedure information 130. -
FIG. 7 is a flow diagram that schematically illustrates a method of presenting, onsemi-transparent screens 114, real-time image 56 of a phacoemulsification procedure, in accordance with an embodiment of the present invention. In apositioning step 140, medical professional 40positions patient 34 so that eye 44 (i.e., the eye to be treated) is within field ofview 32. - In a
first presentation step 142,processor 48 presents real-timevisual spectrum image 30 onsemi-transparent screens 114. To present real-timevisual spectrum image 30 onsemi-transparent screens 114,processor 48 can receive the real-timevisual spectrum image 30 fromcamera 28, generate real-time image 56 from the received image, and transmit, viatransmitter 58, the generated real-time image 56 inwireless signal 62. Upon wireless receiver receivingwireless signal 62,image projector 118 can present real-time image 56 onsemi-transparent screens 114. In embodiments of the present invention,image projector 118 presents real-time image 56 onsemi-transparent screens 114 focused to point 120 in proximity tonear point 122. - In a
specification step 144,processor 48 specifies an image toggling sequence for content to present in real-time image 56 onsemi-transparent screens 114. For example,processor 48 can specify the sequence as follows: -
- A. Real-time visual spectrum image 30 (also referred to herein as image A in the sequence).
- B. Real-time thermal image 38 (also referred to herein as image B in the sequence).
- C. Real-time
thermal image 38 overlaid on real-time visual spectrum image 30 (also referred to herein as image C in the sequence).
In this example,processor 48 can toggle between images A, B and C in a round-robin fashion.
- Presenting real-time visual spectrum image 30 (i.e., image A in the sequence) is described in the
description referencing step 142 hereinabove. To present real-time thermal image 38 (i.e., image B in the sequence),processor 48 can receive the real-timethermal image 38 fromcamera 36, generate real-time image 56 from the received image, and transmit, viatransmitter 58, the generated real-time image 56 inwireless signal 62. Upon wireless receiver receivingwireless signal 62,image projector 118 can present real-time image 56 onsemi-transparent screens 114. - To present real-time
thermal image 38 overlaid on real-time visual spectrum image 30 (i.e., image C in the sequence),processor 48 can receive the real-timevisual spectrum image 30 fromcamera 28, receive the real-timethermal image 38 fromcamera 36, register the receivedthermal image 38 to the receivedvisual image 30, generate real-time image 56 by overlaying the receivedthermal image 38 on the receivedvisual image 30, and transmit, viatransmitter 58, the generated real-time image 56 inwireless signal 62. Upon wireless receiver receivingwireless signal 62,image projector 118 can present real-time image 56 onsemi-transparent screens 114. - Typically,
thermal camera 36 is registered to visual spectrum image camera 30 (or vice versa) prior to the phacoemulsification procedure, using techniques known in the art. For example, an individual (e.g., medical professional 40) can place a heated chessboard atpoint 124, and perform the registration by aligning, ondisplay 70, the thermal and the visual spectrum images of the chessboard. - In an
insertion step 146, medical professional inserts needle intoeye 44, and manipulates handle 82 so that the needle engageslens 81 ineye 44. - In an
emulsification step 148, medical professional 40 starts the phacoemulsification procedure to emulsifylens 81. To emulsifylens 81, medical professional 40 presses button 100 (or in an alternate embodiment a foot pedal), and in response to the pressed button, ultrasonic transducer conveys ultrasonic energy toneedle 88. The ultrasonic energy causes the needle to vibrate and emulsify tissue oflens 81 in proximity toneedle 88. - In a
first decision step 150,processor 48 checks if there is an image toggle request from medical professional 40. In the configuration shown inFIG. 1 , medical professional 40 can send the image toggle request by pressing onpedal 72 or a button located onpedal 72. - If
processor 48 receives an input toggle request, then, instep 152,processor 48, toggles the presentation of real-time image 56 onsemi-transparent screens 114 per the image toggling sequence described supra. - Finally, in a
second decision step 154, if the emulsification oflens 81 is not complete, then the method returns to step 150. The method ends when the emulsification oflens 81 is completed or when indicated by medical professional 40. - Returning to step 150, if
processor 48 does not receive an image toggle request, then the method continues withstep 154. - While the embodiments in steps 150-152 describe toggling the content in real-
time image 56 in response to an image toggle request, other methods of changing the content in real-time image 56 are considered to be within the spirit and scope of the present invention. For example,medical system 20 may comprise first, second and third physical input devices, herein, by way of example, assumed to compriseadditional pedals 72 oradditional buttons 100. In this case, in response to an input from the first input device,processor 48 generates real-time image 56 comprising real-timevisual spectrum image 30, in response to an input from the second input device,processor 48 generates real-time image 56 comprising real-timethermal image 38, and in response to an input from the third input device,processor 48 generates real-time image 56 comprising real-timethermal image 38 overlaid on real-timevisual spectrum image 30. In an additional embodiment,processor 48 can use signals fromvoice recognition module 76 to toggle or select the content in real-time image 56 based on vocal inputs from medical professional 40. - It will be appreciated that the embodiments described above are cited by way of example, and that the present invention is not limited to what has been particularly shown and described hereinabove. Rather, the scope of the present invention includes both combinations and subcombinations of the various features described hereinabove, as well as variations and modifications thereof which would occur to persons skilled in the art upon reading the foregoing description and which are not disclosed in the prior art.
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JP2017079904A (en) * | 2015-10-26 | 2017-05-18 | ソニー株式会社 | Surgical microscope, image processing device, and image processing method |
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EP3852701A4 (en) * | 2018-09-18 | 2022-06-22 | Johnson & Johnson Surgical Vision, Inc. | Live cataract surgery video in phacoemulsification surgical system |
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US20090024023A1 (en) * | 2007-06-08 | 2009-01-22 | Cynosure, Inc. | Thermal surgical monitoring |
US10639104B1 (en) * | 2014-11-07 | 2020-05-05 | Verily Life Sciences Llc | Surgery guidance system |
US20210196384A1 (en) * | 2019-12-30 | 2021-07-01 | Ethicon Llc | Dynamic surgical visualization systems |
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